In Iran, cardiovascular diseases are the most common causes of death. We aimed to perform a systematic review on the prevalence of acute myocardial infarction (AMI) in Iran based on Persian and English papers had been published from 1985 to 2015. Among 267 initially found articles, 142 were excluded; finally, a total number of 40 articles were found relevant which were reduced to 18. Smoking, hypertension, diabetes mellitus, and hypercholesterolemia were the most common risk factors for AMI. Premature MI prevalence was high in men, and smoking was the most common risk factor among young people. People in urban areas were more likely to experience AMI than rural people. The prevalence of AMI in Iran is high and has increased in recent years. Therefore, to restrain the rising trend of AMI, it is necessary to make the primary and secondary prevention efforts.

An 88-year-old woman with a prior history of aortic stenosis and history of valvuloplasty presented with worsening symptoms of heart failure and dizziness. She underwent successful transcatheter aortic valve replacement (TAVR) without complications. Follow-up echocardiograms revealed a small fistula connecting aorta to the right ventricle. The patient was initially asymptomatic but 3 months later developed overload of the right ventricle and heart failure and chose to continue medical therapy. She died of progressive heart failure at 9 months from onset of fistula. Aorto-right ventricular fistula is a rare complication of TAVR with only four cases reported in literature thus far.

The rupture of the right ventricular anterior wall after myocardial infarction is a rare and life-threatening complication associated with high mortality. Early diagnosis by echocardiographic examination and successful treatment is discussed in this case report.

Large intracavitary masses such as those occupying most of a cardiac chamber and obstructing blood flow are not routinely encountered in clinical practice. The differential diagnosis includes neoplastic as well as nonneoplastic causes. Primary cardiac tumors by themselves are uncommon. We hereby report a rare case of a middle-aged female presenting with New York Heart Association Class III symptoms, whose transthoracic echocardiogram revealed a huge mass in right-sided chambers with a novel double ball valve type movement. She successfully underwent urgent surgical resection of the mass with histopathological confirmation of diagnosis.

Pericardial effusion in a renal transplant recipient represents a diagnostic conundrum with a variety of differential diagnoses. Immunosuppressive medications such as sirolimus have been linked to pericardial effusions in the reported literature. Tacrolimus has been reported to be associated with pleural effusions and ascites. We present a case of a patient with tacrolimus as the likely cause of a recurrent pericardial effusion.

Leptospirosis is a zoonotic infection caused by the Leptospira interrogans. Although it is endemic in tropical countries, global incidence has increased in several temperate and developed regions. Here, we present a cardiac magnetic resonance (CMR) and multidetector computer tomography (MDCT) chest features of active systemic leptospiral infection in a 19-year-old male. The MDCT appearances of lungs and CMR appearances of myocardium in icteric leptospirosis are described. Early diagnosis and prompt treatment is important to manage the cardiothoracic complications.

Background: Rotational atherectomy (RA) is used to improve procedural success of percutaneous catheter interventions (PCIs) of complex and heavily calcified coronary lesions. We report the clinical experience and outcomes in our institution with the use of RA, followed by drug-eluting stent implantation.
Materials and Methods: Data of 81 patients treated with PCI and adjunctive RA were analyzed. Clinical follow-up for the occurrence of major adverse events (MAEs) was obtained in all patients and correlated with significant variables using multivariate Cox proportional hazards analysis.
Results: Mean age was 67.9 ± 9.2 years, 61.7% had diabetes, 20.9% had chronic kidney disease, and 48.1% had previous acute coronary syndrome (ACS). Mean SYNTAX score was 29.8 ± 12.2, with a 92.5% angiographic success rate achieved. In-hospital MAEs rate was 7.4% while mortality rate was 8.6%. On median follow-up of 12.2 months, incidence of MAEs of 13.5% with a 75% free incidence from MAEs at 34 months. Multivariate analysis revealed that a history of previous ACS, ejection fraction, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, SYNTAX score, burr to artery ratio, and attainment of angiographic success were significant predictors of MAEs.
Conclusion: RA followed by drug-eluting stent implantation is a safe and effective method in improving procedural success as well as short- and long-term outcomes of PCI in our center. A combination of clinical and procedural factors is predictive for the occurrence of MAEs and should be taken into account in the application of this technique.

The burden of truncus arteriosus in an Urban City in Africa: How are we fairing?Barakat Adeola Animasahun, Aminat Titilayo Ogunlana, Henry Olusegun GbeleeOctober-December 2017, 18(4):121-124DOI:10.4103/1995-705X.221226 PMID:29326774

Background: The true incidence of truncus arteriosus in underdeveloped countries is difficult to determine. This is due largely to underreporting as a result of nonavailability of technologically advanced facilities to make definitive diagnosis prenatally. There is a lack of data on the profile and outcome of patients with persistent truncus arteriosus (PTA) in Nigeria. This study aims to document the demographic characteristics, mode of presentation, indications for echocardiography, associated anomalies, average age at diagnosis, and outcome of patients with truncus arteriosus in our center.
Methods: Prospective and cross-sectional involving consecutive patients diagnosed with PTA using echocardiography at the Paediatric Department of Lagos State University Teaching Hospital, Lagos, Nigeria as part of a large study between January 2008 and December 2015.
Results: Only 25 patients had PTA during the study period. The prevalence of PTA among children presenting at the study center during the study period was 7.9/100,000. It constituted 2.4% of the cases of congenital heart disease and 7.1% of cases of cyanotic congenital heart disease. The male:female ratio was 1:1.1. The ages of the patients at diagnosis ranged between 0.75 and 153 months with a mean age at diagnosis ± standard deviation of 18.4 months ± 37.7. Only about 40% of patients were diagnosed within the neonatal period. Cyanosis was the most frequent indication for evaluation.
Conclusion: PTA is as common in Nigeria as in the other parts of the world but diagnosed late. Cyanosis is the most common presenting feature.